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Fluoroquinolone-resistant Pseudomonas aeruginosa: risk factors for acquisition and impact on outcomes

Donald I Hsu1, Mark P Okamoto, Rekha Murthy

  • 1School of Pharmacy, University of Southern California, 1985 Zonal Avenue, Los Angeles, CA 90033, USA.

The Journal of Antimicrobial Chemotherapy
|February 25, 2005
PubMed
Abstract

Insights

Fluoroquinolone (FQ) exposure is a key driver of FQ-resistant Pseudomonas aeruginosa. This resistance leads to delayed effective treatment and poorer patient outcomes, including increased mortality.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Clinical Pharmacy

Background:

  • Rising rates of Pseudomonas aeruginosa resistance to fluoroquinolones (FQ) correlate with increased FQ prescribing.
  • Understanding risk factors and outcomes associated with FQ resistance in P. aeruginosa is critical.

Purpose of the Study:

  • To identify risk factors for FQ resistance in P. aeruginosa.
  • To evaluate the impact of FQ resistance on patient outcomes.
  • To analyze the role of empirical FQ use in Pseudomonas infections.

Main Methods:

  • A case-control study involving hospitalized adult patients.
  • Comparison of FQ-resistant (cases) and FQ-susceptible (controls) P. aeruginosa isolates.
  • Analysis of risk factors and patient outcomes.

Main Results:

  • Independent risk factors for FQ resistance included FQ exposure, nosocomial acquisition, and diabetes mellitus.
  • FQ-resistant cases experienced a significant delay in effective therapy (3.5 days vs. 1 day).
  • Poorer outcomes in FQ-resistant cases included lower response rates, longer time to clinical stability, and higher infection-related mortality.

Conclusions:

  • Widespread FQ prescribing contributes to FQ resistance in P. aeruginosa, a modifiable risk factor.
  • Empirical FQ therapy for Pseudomonas infections may delay effective treatment and lead to adverse outcomes.

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